Organization Active NPI

Caldwell County Health Department

  • Public Health or Welfare Agency
  • Kingston, MO
National Provider Identifier
1386718682
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
CALDWELL COUNTY HEALTH DEPARTMENT
Practice address
275 South Washington Street
Kingston, MO 64650-0066
Phone
(816) 586-2311
Fax
(816) 586-2603
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shelly Sims, RN BSN
Title
Administrator
Phone
(816) 586-2311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

275 South Washington Street
Kingston, MO 64650-0066

Mailing address

275 South Washington Street
PO Box 66
Kingston, MO 64650-0066
Phone (816) 586-2311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211105000946 MO Part B Supplier - Clinic/Group Practice 8224030085 Receives reassigned benefits from 1 practitioner
Practice locations: Kingston, MO

National Provider Directory

National Provider Directory

Locations

255 W Main St
Kingston, MO 64650
Phone (816) 586-2311

275 S Washington St
Kingston, MO 64650
Phone (816) 586-2311

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386718682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SOUTH WASHINGTON STREET",
            "address_2": "PO BOX 66",
            "city": "KINGSTON",
            "state": "MO",
            "postal_code": "646500066",
            "telephone_number": "816-586-2311",
            "fax_number": "816-586-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SOUTH WASHINGTON STREET",
            "city": "KINGSTON",
            "state": "MO",
            "postal_code": "646500066",
            "telephone_number": "816-586-2311",
            "fax_number": "816-586-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "816-586-2311",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.